Intraluminal ultrasound guidance of transverse laser coronary atherectomy.

Catheter systems for laser atherectomy in peripheral and coronary arteries are subject to many design constraints. Ideal mechanical, laser and imaging requirements for these systems are proposed, and compared to the design features of a laser atherectomy system currently under development by Intra-Sonix. This system uses high resolution ultrasound for real-time guidance and control and is potentially capable of characterizing lesions and imaging critical structures in the coronary arteries, to guide physicians in the application of laser therapy. Precise catheter location and rotational direction can be provided continuously as the therapeutic intervention proceeds. Examples are given of the imaging modes and ultrasound images of an artery produced by the Intra-Sonix system.